Elbow dislocations have been classified into 6 different categories with most usual the posterior type

Size: px

Start display at page:

Download "Elbow dislocations have been classified into 6 different categories with most usual the posterior type"

Kory Norman
5 years ago
Views:

1 21st Congress of the European Society for Surgery of the Shoulder and the Elbow A COMPARATIVE STUDY BETWEEN EARLY AND LATE MOBILIZATION OF SIMPLE ELBOW DISLOCATIONS LasanianosN 1 ; MouzopoulosG 1 ; MorakisE 1 ; NikolarasG 1 ; Exarhos D 2 ; GarnavosC 3 1 1st Orthopaedic Department; 2 Radiology Department; 3 2nd OrthopaedicDepartment General Hospital "Evangelismos ; Athens- Greece Simple Dislocations No accompanying fractures Elbow dislocations have been classified into 6 different categories with most usual the posterior type

2 Patients & Methods Two Patients Groups (n1=10, n2=9) with median age 35y. Reduction was performed by a 2 doctors collaboration after anaesthetic regional infiltration into the post-traumatic haematoma. 1 st Study Group 2 nd Study Group (7 men 3 women) (5 men 4 women) Post reduction immobilization in a sling, at 90 degrees of flexion, for 2 weeks followed by active mobilization afterwards a)immobilization in a sling for 3 days at 90 degrees of flexion b)active mobilization on a flexion-extension axis (by the use of a functional brace) for 3 weeks. c)release of supination-pronation movements by the 3 rd week.

$reduction No iatrogenic fracture was recorded The Mayo Elbow Performance Score was used for evaluation Myositis$ ossificans was observed in one patient of the late mobilization group No case of recurrent dislocation was

ossificans was observed in one patient of the late mobilization group No case of recurrent dislocation was

3 Methods & Results Final follow-up mean time: 8 months No neurovascular lesion was recorded, pre or post reduction No iatrogenic fracture was recorded The Mayo Elbow Performance Score was used for evaluation Myositis ossificans was observed in one patient of the late mobilization group No case of recurrent dislocation was recorded in any group A simple posterior elbow dislocation Elbow ROM 3 weeks post reduction Full Elbow ROM 5 weeks post reduction

4 Μayo Elbow Performance Score Final Range of Motion (ROM) Late Mobilization group Early Mobilization group 15/20 20/20 Joint stability 10/10 10/10 Pain 45/45 45/45 Funcionality 15/25 20/25 Total Score 85/100 95/100

5 Literature references Immediate reduction followed by no more of 1 to 5 days of immobilization Protzman RR. Dislocation of the elbow joint. J Bone Joint Surg. 1978; 60A: The surgical repair of the collateral ligaments has not proven to offer better results than those of non-surgical treatment Josefsson P et al. Surgical versus non-surgical treatment of ligamentous injuries following dislocation of the elbow joint. A prospective randomized study. J Bone Joint Surg [Am]. 1987; 69: Long periods of immobilization have not proven to be effective Riel KA, Bernett P. Simple elbow dislocation. Comparison of long-term results after immobilization and functional treatment. Unfallchirurg. 1993; 96: The disadvantages of immobilization have been widely recognized (e.g. pain, persistent stiffness, late degenerative changes etc ) Salter RB. The physiologic basis of continuous passive motion for articular cartilage healing and regeneration. Hand Clin. 1994; 10: Early and late mobilization provide similar joint stability. Nevertheless a non immobilization protocol has achieved 95% success Ross G et al. Treatment of simple elbow dislocation using an immediate motion protocol. Am J Sports Med. 1999; 27:

6 Conclusion The joint stability and sensitivity do not seem to relate with the post reduction period of immobilization The final Range of Motion and the functionality of the elbow joint are statistically improved in the early mobilization group in comparison with the late mobilization group Early mobilization of the elbow joint after simple dislocations is the best way of treatment for the best functional results Patients shall be persuaded to follow early active elbow mobilization, initially at the flexion-extension axis and later at all axis

Orthopaedic Department; 2 Radiology Department; 3 2nd OrthopaedicDepartment General Hospital

7 A COMPARATIVE STUDY BETWEEN EARLY AND LATE MOBILIZATION OF SIPMLE ELBOW DISLOCATIONS LasanianosN 1 ; MouzopoulosG 1 ; MorakisE 1 ; NikolarasG 1 ; Exarhos D 2 ; GarnavosC 3 1 1st Orthopaedic Department; 2 Radiology Department; 3 2nd OrthopaedicDepartment General Hospital "Evangelismos ; Athens- Greece 21st Congress of the European Society for Surgery of the Shoulder and the Elbow

Rehabilitation after Total Elbow Arthroplasty

Rehabilitation after Total Elbow Arthroplasty Total Elbow Atrthroplasty Total elbow arthroplasty (TEA) Replacement of the ulnohumeral articulation with a prosthetic device. Goal of TEA is to provide pain